Thomas Martin Clark, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

725069 Issued in NY

Practice address

9300 Dewitt Loop
Fort Belvoir, VA 22060-5285

Phone

(571) 231-3224

NPI assigned

Jul 19, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY, MN2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Baylor College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Anesthesia Providers LLCGroup PAC ID 7315986064, 325 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

Merit-based Incentive Payment System (MIPS)

Final score

86.77 of 100Reported as group

Quality

88.12

Improvement activities

40

Cost

77.69

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: thomas.m.clark134.mil@mail.mil

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University Anesthesia Providers, LLC

  • Anesthesiology Physician
  • Minneapolis, MN
  • NPI 1699711143

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Jefferson Anesthesiologist Services PC

  • Anesthesiology Physician
  • Watertown, NY
  • NPI 1508818014
  Medicare reassignment NPD
• Metropolitan Anesthesia Network, LLP

  • Anesthesiology Physician
  • Plymouth, MN
  • NPI 1558314427

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1316008212
  Care Compare affiliation
• Fairview Health Services

  • Skilled Nursing Facility
  • Minneapolis, MN
  • NPI 1669459913

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1588237663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 CHURCH ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223144203",
            "telephone_number": "516-754-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "571-231-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "THOMAS",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-19",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "725069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Thomas.M.Clark134.mil@mail.mil",
            "affiliation": "N",
            "endpointDescription": "Military Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9300 DeWitt Loop",
            "city": "Fort Belvoir",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220605285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Youn Kee Chung, M.D.
• Randal Cieslak, DO
• Francesca Maria Cimino, MD
• Jessica Lynn Cindass, M.D.
• Raven Claiborne
• Christina N Clay, OTR/L
• Kevin Jude Matthew a Climaco, MD
• Tiffany Cline, PHARM.D., RPH
• Abigail W Cobey, PSY.D.
• David Paul Coen, OTR/L

• Certified Registered Nurse Anesthetist in Fort Belvoir, VA
• Providers in Fort Belvoir, VA by specialty
• Certified Registered Nurse Anesthetist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.